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Never mind that report on Medicaid

By Carol Gentry
8/17/2009 © Health News Florida

The federal government would pay 100 percent of the cost of expanding Medicaid coverage under all health-reform bills now pending in Congress. States wouldn't have to pay anything until at least 2014 under any version in the House or Senate.

So  a reportthat health reform would add $1.6 billion to the annual cost of Florida Medicaid was, apparently, incorrect. The article appeared in two major state newspapers, the Orlando Sentinel and the South Florida Sun-Sentinel, on Friday. it carried a sky-is-falling headline: “Florida leaders warn health care reform could bankrupt Medicaid."

Sun-Sentinel reporter Josh Hafenbrack wrote that if federal health reform expanded the number of Floridians covered under Medicaid from 2.6 million to 4 million, it would cost the state Medicaid budget an extra $1.6 billion. He got that figure from a chart AHCA sent him that calculated the cost of expansion based on what it pays now -- about one-third -- with the federal government picking up two-thirds. 

However, that's not the scenario described in any version of America’s Affordable Health Choices Act, as Tallahassee health-care consultant Brady Augustine, a former Florida Medicaid official, notes in his blog,

AHCA spokeswoman Shelisha Durden said Hafenbrack spoke with Chief of Stafaf Tom Arnold. She said Arnold wasn't available for an interview today with Health News Florida.

It does not appear that the reporter double-checked the House and Senate bills, which are posted online. 

On Friday, as soon as he saw the erroneous newspaper article, Augustine issued a warning on Twitter. Health News Florida, unable to reach Hafenbrack, omitted a link to the story in Friday's e-Alert. On Saturday, Augustine wrote more on his blog under the headline: “Are states entering the misinformation fray?”
Despite the teasing headline, Augustine didn’t suggest that top officials at AHCA -- whose Secretary, Holly Benson, is a Republican -- were deliberately trying to mislead the public. He said it was “probably an honest oversight.” 

Still, he said, “It is essential right now that all information regarding the potential effects of health reform is properly vetted and placed in its proper context. As we have seen all too often this month, ‘once it’s out there, it’s out there’ – accurate or not.” 

The newspaper article quoted several Florida lawmakers fretting over the numbers. House Majority Leader Adam Hasner, R-Boca Raton, was quoted as saying: "Our Medicaid program is bordering on unsustainable as it is. If you add this component, you are going to break the back of Florida and every other state." 

Sen. Nan Rich, D-Weston, was quoted as pointing out the offsetting reduction in costs the state now covers when the uninsured -- nearly 4 million -- are forced to seek treatment in emergency rooms.

Today, Rich told Health News Florida that it was "very foolish" of AHCA to come out with a predicted impact on Medicaid without waiting to see what the legislation actually says. 

"It just scares people," she said.

A health-reform advocacy group, Florida CHAIN, asked the newspapers to run a correction or clarification. An editor at the Orlando paper said the decision would have to come from Fort Lauderdale, since Hafenbrack reports to an editor there.

Policy Director Greg Mellowe, pointing to the thread of e-mails, says it's clear to him that the error originated at AHCA. Hafenbrack requested "the report that Tom Arnold mentioned during our phone call yesterday, showing how many Medicaid beneficaries would be added to Florida's rolls and the cost under various health care proposals being debated in Washington."

The return e-mail from AHCA presented a dollar figure for three varying income levels, but each presupposes a 2:1 federal-state match.  

Those who want to see for themselves what the pending bills say can check the House version, HR 3200, Section 1701, pages 739-745. It's called the "Tri-Committee" bill because three committees have worked on it. 

To understand it, you need to know that "100% FMAP," which stands for Federal Medical Assistance Percentage, means the entire amount is covered by the federal government. Two of the committees would keep the 100% coverage until 2015, while one keeps the original language of 2014; after that, states are expected to contribute in a gradual phase-in. 

The Senate Health, Education, Labor and Pensions (HELP) Committee's language is easier to understand. Here is the bill; go to page 37, where it says that states will receive a federal medical assistance percentage of 100 percent until 2015, after which it would be phased down over five years. 

The Senate version would expand Medicaid to those who have a family income up to 150 percent of the official federal poverty level, while the House version expands up to 133 percent.

A chart that makes the House and Senate legislation easy to check has been posted by the Kaiser Family Foundation. 

--Carol Gentry, Editor, can be reached at 727o-410-3266 or by e-mail.